If you were asked the leading cause of disability in America, what would your answer be? Consider your response carefully, as I can almost assure you that it is not any of the illnesses you are contemplating.
Could it be diabetes? This ailment certainly affects a significant portion of the adult public. Most of us have an acquaintance or two that suffers from the disease. How about depression? Sure, it's not a condition normally associated with disability, but it can certainly curtail the activities of an individual to a crippling degree.
Obesity, you might be thinking -- a valid suggestion, to be sure. On the other hand, there are probably a number of huskier Americans who might just take issue with obesity being considered a disability. Well, how about heart problems? We are all friends with at least one person who eats way too many cheeseburgers. No?
You've given up already? Only because I would never want to cause undue mental anguish to my readers, I'll tell you the answer. The number one cause of disability in these United States is Arthritis in all its forms.
Yes -- arthritis. The disease generally associated, albeit incorrectly, with elderly patients and retired sports stars. Unexpected, isn't it? Yet it also makes sense -- at least numerically. According to the Centers for Disease Control, as of 2009, 22.2 percent of Americans over the age of 18 suffer from this debilitating illness. That's just about 50 million people.
This means that as you walk down the street today, every 50 human being you pass is a strong candidate for being affected by arthritis.
Of course, after you have the answer and you have kicked it around for a while, you will likely realize the logic of it. The part that defies logic, though, is yet to come. Despite being the most prevalent cause of disability, Arthritis in all its forms is still one of the most misunderstood illnesses that exist today.
Ask yourself this question. If I told you to choose who would be more likely to contract rheumatoid arthritis, whom would you select? Would it be the elderly man shuffling through his house with the aid of a walker, or would it be the teenage girl who just came running off the soccer field? Putting aside the fact that you have probably figured out my ruse, I'm sure if you are honest with yourself, you will admit to having chosen the former. It makes perfect sense, of course. Old people get arthritis -- everybody knows that. The only problem is that in the case of rheumatoid arthritis, which is an autoimmune disease, the age of affect begins at birth.
The simple fact that osteoarthritis and rheumatoid arthritis are two distinct and mainly unrelated illnesses is lost upon most of the population. Osteoarthritis is generally experienced by older men and women, and is a joint condition that results from years of use and abuse. This is the "arthritis" that everyone speaks of, even when it may not apply. Because of an unfortunate coincidence in the similarity of symptoms, rheumatoid arthritis shares the same name while not sharing any of the underlying causes. R.A. is an auto-immune disease where the body continuously and viciously attacks its own joints as if they were foreign antibodies -- antibodies that must be destroyed.
The differences do not end there. Osteoarthritis tends to affect the same joints every day, while Rheumatoid travels from joint to joint on a schedule that is unique to each patient. Osteoarthritis is mostly contained within the joint itself, while rheumatoid arthritis has systemic effects such as low-grade fevers and severe fatigue. Osteoarthritis, in general, is controlled with the use of over-the-counter drugs, while rheumatoid arthritis may require the use of chemotherapy and next-generation bio-treatments. The list of differences goes on and on, but as a rule of thumb, rheumatoid is much more severe. The two forms of the disease could not be more dissimilar, and these are just two of the many other types of arthritis that we know of.
Most of you reading this have likely identified yourself as culprits to one or more of the "knowledge crimes" mentioned above. Even I was guilty of believing many arthritis-related falsities before I educated myself. The lack of knowledge knows no boundaries either -- I have met medical doctors who believed some of the more common misconceptions. Arthritis, which is expected to affect almost 10 million more Americans by the year 2030, remains one of the most misunderstood diseases in our nation.
If I haven't piqued your interested yet, let me leave you with one final thought. When you began reading this article, there was a good chance that you guessed one of the more commonly understood diseases as the answer to the question posed in the title. Maybe you guessed twice, or even three times, before arriving at the correct reply. Assuming you named some of the more common causes of disability, combine the number of affected men and women for all three of your guesses, and you may just equal the segment of the populace who are afflicted with arthritis -- a truly significant amount.
Cheng YJ, Hootman JM, Murphy LB, Langmaid GA, Helmick CG. Prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation -- United States, 2007-2009. MMWR 2010;59(39):1261-1265.
"Future Arthritis Burden" Centers for Disease Control and Prevention -- Your Online Source for Credible Health Information 20 Oct. 2010. 3 Feb. 2011
http://www.biblehealth.com/arthritis/causes-of-arthritis.html
Another aspect of knowledge gap, again alluded to here, is that osteoarthritis is an "elderly" disease. I am only 40 years old and have severe OA in my knee and neck. I'm not overweight, and while I have always been active and exercised, I've never participated in anything extreme like marathon running or gymnastics that might have led to joint injury.
It's really quite frustrating trying to find information on OA that is not directed at the 60+ crowd. My doctors have told me to basically rock on until it's time for knee replacement. Not much support or advice other than take alleve when I hurt.
I've started a blog for us not quite old folks who wish to remain active despite this debilitating disease.
http:/www.down-dog-amy.blogspot.com
osteoarthritis - particularly in someone so young might well be linked to coeliac disease and even gluten sensitivity. It's pretty easy to look up - my advice would be get tested :)
(coeliac is also more commonly linked to rheumatoid arthritis)
I think that the state of health care in the U.S. today is fairly confusing and that makes dealing with arthritis worse and helps perpetuate myths about it. GPs are overwhelmed, specialists are very expensive, and even with insurance a person can rack up significant bills and still not get help. If you have an acute problem like a broken arm or a heart attack, your concern will be efficiently addressed and it will be addressed well. We're good at dramatic problems and emergencies. But if you have a chronic illness like arthritis, it can take years of doctor hopping to even get an accurate diagnosis, never mind effective treatment and pain management.
While it isn't possible to prevent either osteoarthritis OR rheumatoid arthritis, there are a few common sense strategies people can employ to keep their general health up and reduce some of the effects or even delay onset. Things like maintaining a normal weight (to reduce pressure on joints) and eating well (to reduce inflammatory reactions to foods) can help, as can regular exercise:
http://www.natural-arthritis-pain-relief.org/arthritis-prevention.html
In general though, I think we need a more common sense, early intervention approach to chronic diseases in this country. Early intervention is cheap. Shuffling from doc to doc until the situation is critical (which is what often happens now) is expensive for everyone.
The article "Prevalence and Most Common Causes of Disability Among Adults --- United States, 2005" can be found at:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5816a2.htm
http://www.cdc.gov/arthritis/data_statistics/national_nhis.htm#gender_specific
An eating plan that eliminates the top nine allergenic foods worldwide, which are: dairy, wheat, eggs, peanuts, soy, tree nuts, fish, shellfish, and seeds might be helpful.
Theories abound that some causes of arthritis may be infectious in nature. Dental health could be a factor, and the proper removal of mercury amalgams and root canals could prove of benefit.
Regarding the use of supplements to alleviate arthritis pain, a fascinating and inexpensive approach, known as the Kaufman protocol, is the use of niacinamide (not niacin). Here is some background info on it:
http://www.arthritistrust.org/Articles/JWrightInterviewsWilliamKaufman.pdf
Roy Mankovitz, Director
http://www.MontecitoWellness.com
A research organization